SIU Lead Investigator

We need to output HTML fragment with sections: About the role, Responsibilities, Requirements (maybe Qualifications), Skills, Benefits, Pay, Schedule. Only include sections with real content. We need to parse the posting. First, remove boilerplate: navigation, EEO, legal, etc. Keep substantive info. Let's extract sections: - About the role: The first paragraph(s) describing Optum, mission, culture, etc. Probably "About the role" includes description of the job: "Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers..." etc. So we can put that as About the role. - Responsibilities: The list under "Primary Responsibilities" bullet points. - Requirements/Qualifications: The "Required Qualifications" list and maybe "Preferred Qualifications". Could combine as Requirements (including required and preferred). But we need separate sections? The instruction: use headings for section headings e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. So we can have Requirements and Qualifications separate if content exists. But we can also combine if not enough. However we have both required and preferred qualifications; we could put Required Qualifications under Requirements, Preferred Qualifications under Qualifications. Or we could put all under Requirements and skip Qualifications. But better to follow headings if we have content. - Skills: maybe list of skills like proficiency in Excel, Word, etc. Could be under Skills. - Benefits: mention comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution, telecommute flexibility. - Pay: salary range $72,800 to $130,000 annually. - Schedule: maybe telecommute flexibility, but schedule not explicitly given besides telecommute. Could include "Schedule: Flexible telecommuting within U.S." Might be considered schedule. The posting says "You will enjoy the flexibility to telecommute* from anywhere within the U.S." That's schedule/location. We'll include Schedule section. Now we need to ensure we don't include filler like "commensurate with experience". Not present. We need to remove duplicated lines, cookie/navigation/legal/EEO etc. Also remove "Application Deadline", "Job posting may come down early", "At UnitedHealth Group, our mission..." etc. Also remove EEO statements, drug-free workplace, etc. We need to preserve all substantive information. Let's extract substantive paragraphs: Intro: "Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together." Then: "Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips, complaints, external intelligence or behavior data, the medical community and law enforcement, employee's conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations. Identify, communicate, and recover losses as deemed appropriate. These investigations may include participation in telephone calls or meetings with providers, members, clients, legal, compliance, and other investigative areas and requires adherence to state and federal compliance policies, reimbursement policies, and contract compliance. Where applicable, testimony regarding the investigation may be required in a court of law. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges." Then "Primary Responsibilities" list (multiple bullet-like sentences). We'll convert to

• . Then: "You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in." This could be part of Benefits or maybe a general statement; but we can include under Benefits maybe. Then "Required Qualifications" list. Then "Preferred Qualifications" list. Then: "All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. For more information on our Internal Job Posting Policy, click here." This is maybe metadata; we could drop as minor metadata. Then: "Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable." Then: "Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records." This is EEO-like; maybe drop as boilerplate? It's a specific legal statement but could be considered EEO/legal. The instruction says remove EEO/equal-opportunity/scam-warning boilerplate. So drop that. Then: "Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants." Drop. Then: "At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN" All drop. Now we need to structure. Sections:

  About the role

  -> combine the introductory paragraphs (Optum description + employee responsibilities description?) Actually the responsibilities description is more about role duties; but we already have a Responsibilities section for primary responsibilities. The "Employees are responsible for triaging..." could be part of About the role (general description). We'll include that. Thus About the role: paragraphs: "Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together." Plus maybe the sentence: "Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips, complaints, external intelligence or behavior data, the medical community and law enforcement, employee's conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations. Identify, communicate, and recover losses as deemed appropriate. These investigations may include participation in telephone calls or meetings with providers, members, clients, legal, compliance, and other investigative areas and requires adherence to state and federal compliance policies, reimbursement policies, and contract compliance. Where applicable, testimony regarding the investigation may be required in a court of law. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges." But the telecommute flexibility could go to Schedule section. However it's part of role description; we could keep it in About the role or Schedule. Since Schedule section is for schedule details, we could put telecommute there. But the instruction: include a section ONLY when posting has real, specific content for it. The posting does mention telecommute flexibility, so we can have Schedule section with that. Thus About the role will exclude the telecommute sentence. Let's split: About the role: Optum description + culture + mission. Then Responsibilities: list of primary responsibilities. Then Requirements: Required Qualifications. Then Qualifications: Preferred Qualifications. Then Skills: maybe list of skills like proficiency in Excel, Word, etc. Could be extracted from Required Qualifications: "Intermediate level of proficiency in Microsoft Excel (pivot tables and macros) and Word (creating, editing, and saving documents)" plus "Familiar with CPT code terminology". Also "2+ years of experience with computer research", "2+ years of experience with regulatory compliance", "2+ years of experience with data analysis as it relates to financial recovery/settlements". Those could be skills/experience. But we already have Requirements covering experience. Skills could be separate for technical proficiencies. We'll include Skills: Intermediate level of proficiency in Microsoft Excel (pivot tables and macros) and Word (creating, editing, and saving documents); Familiar with CPT code terminology. Then Benefits: comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution, plus maybe "You'll be rewarded and recognized for your performance..." and "comprehensive benefits and career development opportunities" from intro. Also telecommute flexibility? Actually telecommute goes to Schedule. Then Pay: salary range $72,800 to $130,000 annually. Then Schedule: flexibility to telecommute from anywhere within the U.S. We must ensure we don't repeat content. Let's craft each section. About the role: combine two paragraphs. Paragraph1: "Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together." Paragraph2: "Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips, complaints, external intelligence or behavior data, the medical community and law enforcement, employee's conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations. Identify, communicate, and recover losses as deemed appropriate. These investigations may include participation in telephone calls or meetings with providers, members, clients, legal, compliance, and other investigative areas and requires adherence to state and federal compliance policies, reimbursement policies, and contract compliance. Where applicable, testimony regarding the investigation may be required in a court of law." That seems good. Responsibilities: list each bullet from "Primary Responsibilities". Let's extract them: - Perform root-cause and trend analysis and translate findings into prevention (policy recommendations, new detection rules, training opportunities, control improvements). - Utilize appropriate documentation and tracking controls in the case tracking system to ensure compliance and auditability requirements are met. - Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. - Gather all relevant facts to articulate behavior through an Investigation Summary and compliance package. - Collaborate